A recent study has investigated whether maintaining good cardiovascular health in the first trimester of pregnancy can offset the genetic risk of developing gestational hypertension and preeclampsia. Researchers analyzed data from over 5,000 first-time pregnancies to determine how these hypertensive disorders develop during pregnancy.
Washington: According to new research, maintaining strong cardiovascular health in the first trimester of pregnancy could reduce the genetic risk of developing conditions like preeclampsia and gestational hypertension. The preliminary findings were shared at the American Heart Association’s Hypertension Scientific Sessions 2024 in Chicago, which took place from September 5-8, 2024.
These sessions are a major platform for sharing new developments in the research and treatment of hypertension and its links to heart disease, kidney disease, stroke, obesity, and genetics.
Preeclampsia And Gestational Hypertension
Hypertensive disorders, such as preeclampsia and gestational hypertension, are significant causes of maternal and fetal death. A person’s genetic background can influence their risk of developing these conditions through a validated model known as a polygenic risk score. However, it remains unclear how cardiovascular health during early pregnancy, assessed using the American Heart Association’s Life’s Essential 8 (LE8) scoring system, affects the risk of hypertensive disorders.
“We wanted to explore if early cardiovascular health could reduce the risk of preeclampsia or gestational hypertension, even for those at high genetic risk,” said study co-author Vineetha Mathew, a fourth-year M.D. candidate at Tufts University School of Medicine. “Our findings suggest that maintaining better cardiovascular health in the first trimester could mitigate the risk of hypertensive disorders, regardless of genetic risk.”
Study Analysis And Key Findings
The study analyzed whether early pregnancy cardiovascular health can counteract genetic risks for gestational hypertension and preeclampsia. Researchers assessed data from over 5,000 individuals experiencing their first pregnancies.
For the analysis, each participant’s genetic risk was classified using a polygenic risk score. This score predicts a person’s susceptibility to diseases based on the combined effect of millions of genetic variants.
Additionally, a cardiovascular health score, adapted from the Life’s Essential 8 criteria, was assigned to each individual.
Seven components—diet, physical activity, sleep, nicotine exposure, diabetes, baseline blood pressure, and body mass index—were incorporated into the score, while cholesterol was measured for a subgroup (47%) of participants.
The analysis adjusted for several factors, including age, self-reported race and ethnicity, education level, and marital status.
It also examined the association between cardiovascular health, genetic risk, and the development of hypertensive disorders like preeclampsia and gestational hypertension.
“What was striking about our results was how cardiovascular health in early pregnancy seemed protective for everyone, regardless of genetic risk,” Mathew said. “In fact, individuals with high genetic risk but favorable cardiovascular health had a similar, or even lower, chance of developing a hypertensive disorder than those with low genetic risk but poor cardiovascular health.”
Importance of Cardiovascular Counseling
Mathew emphasized the significance of cardiovascular health counseling before and during pregnancy. “Our research underscores the importance of focusing on cardiovascular health early, even before conception,” she said. “Primary care physicians and OB-GYNs should encourage patients to maintain healthy nutrition, weight management, and optimal blood pressure before and during pregnancy to prevent complications.”
Mathew added that prevention is now at the forefront of medicine, noting that starting early with cardiovascular health improvements can not only affect pregnancy outcomes but also reduce the risk of cardiovascular disease later in life.
Study Limitations And Future Directions
One limitation of the study was that cholesterol data was missing for about half of the participants. The researchers plan to expand the study to include more diverse populations and explore cardiovascular health metrics throughout pregnancy, as well as in subsequent pregnancies.
Donald M. Lloyd-Jones, M.D., chair of the writing group for the American Heart Association’s Presidential Advisory unveiling Life’s Essential 8, praised the study. “These results highlight the critical role of cardiovascular health during pregnancy, demonstrating that maintaining a healthy lifestyle can help mitigate genetic risks,” he said. Lloyd-Jones, who is also the chair of preventive medicine at Northwestern University’s Feinberg School of Medicine, added, “The reductions in risk for hypertensive disorders associated with better cardiovascular health show that we have the ability to help patients avoid potentially dangerous pregnancy complications.”
The findings stress the importance of early intervention and lifestyle changes to promote heart health in pregnancy, which can influence both maternal and child health in the long term.